Caroline Oliver, a World authority on building high performing boards using the Carver Policy Governance model, has responded to the situation at Mid Staffordshire NHS foundation trust (see below) with a short article titled ‘Danger – Targets at Work’.
According to Caroline, the main problem in the NHS currently is that “assurance systems are often assuring the wrong things, by which I mean that they are assuring compliance with matters of means rather than ends.”
Healthcare Governance Review believes that had the Mid Staffordshire board been focused on ends (i.e. organisational purpose) rather than fixated on various means issues, the outcome for many patients who allegedly died unnecessarily might have been very different.
Caroline states that “the work of boards in healthcare really matters.” Further, she believes that “the immediate hope for progress in terms of distinguishing ends from means lies with NHS boards who are the only people at local level who have the authority to require an ends focus and to hold themselves and their organisations accountable for the fulfillment of same. When boards define ends they are defining their organisation’s real bottom line – the criteria against which everything they do should ultimately be judged. When boards define ends they are providing meaningful leadership. Yes they need to ensure that everything about the organisation is legal, prudent and ethical, but without ever losing sight of the organisation’s purpose.”
You can read Caroline’s full article, Danger – Targets at Work, on her website here.